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Brandolini J, Bertolaccini L, Pardolesi A, Solli P. Surgical treatment of synchronous multiple neuroendocrine lung tumours (case series): is more always better? ANNALS OF TRANSLATIONAL MEDICINE 2017; 5:423. [PMID: 29201875 DOI: 10.21037/atm.2017.08.13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Pulmonary neuroendocrine lung tumours are uncommon neoplasm; the presence of multiple and synchronous lesions is rare, and few case report are described in the literature. We present a case series of three patients without particular symptom and radiologic finding of multiple synchronous pulmonary nodules. All the patients underwent surgical treatment; histopathologic examination revealed typical carcinoid tumours in all three cases (one patient has a synchronous atypical carcinoid). No oncological progressions were observed at follow-up. A review of current literature is also presented with a suggested strategy management.
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Affiliation(s)
- Jury Brandolini
- Department of Thoracic Surgery, AUSL Romagna Teaching Hospitals, Forlì, Italy
| | - Luca Bertolaccini
- Department of Thoracic Surgery, AUSL Romagna Teaching Hospitals, Forlì, Italy
| | | | - Piergiorgio Solli
- Department of Thoracic Surgery, AUSL Romagna Teaching Hospitals, Forlì, Italy
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Chong CR, Wirth LJ, Nishino M, Chen AB, Sholl LM, Kulke MH, McNamee CJ, Jänne PA, Johnson BE. Chemotherapy for locally advanced and metastatic pulmonary carcinoid tumors. Lung Cancer 2014; 86:241-6. [PMID: 25218177 DOI: 10.1016/j.lungcan.2014.08.012] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Revised: 08/19/2014] [Accepted: 08/19/2014] [Indexed: 01/17/2023]
Abstract
OBJECTIVES The optimal management of locally advanced and metastatic pulmonary carcinoid tumors remains to be determined. MATERIALS AND METHODS A retrospective review was conducted on patients with typical and atypical pulmonary carcinoid tumors treated at our institutions between 1990 and 2012. RESULTS 300 patients were identified with pulmonary carcinoid, (80 patients with atypical carcinoid), of whom 29 presented with metastatic disease (16 atypical). Of evaluable patients, 26 (41%) with stages I-III atypical carcinoid tumors recurred at a median time of 3.7 years (range, 0.4-32), compared to 3 (1%) patients with typical carcinoid (range, 8-12.3). 39 patients were treated with chemotherapy, including 30 patients with metastatic disease (27 atypical), and 7 patients were treated with adjuvant platinum-etoposide chemoradiation (6 atypical, 1 typical, 6 stage IIIA, 1 stage IIB). At a median follow-up of 2 years there were 2 recurrences in the 7 patients receiving adjuvant treatment. Median survival after diagnosis of metastatic disease for patients with atypical pulmonary carcinoid was 3.3 years with a 5-year survival of 24%. Treatment regimens showing efficacy in pulmonary carcinoid include 15 patients treated with octreotide-based therapies (10% response rate (RR), 70% disease control rate (DCR), 15 month median progression-free survival (PFS)), 13 patients treated with etoposide+platinum (23% RR, 69% DCR, 7 month median PFS), and 14 patients treated with temozolomide-based therapies (14% RR, 57% DCR, 10 month median PFS). 8 of 10 patients with octreotide-avid disease treated with an octreotide-based regimen experienced disease control (1 partial response, 7 stable disease) for a median of 18 months (range 6-72 months). CONCLUSIONS These results support our previous finding that a subset of pulmonary carcinoid tumors are responsive to chemotherapy.
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Affiliation(s)
- Curtis R Chong
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, United States
| | - Lori J Wirth
- Massachusetts General Hospital Cancer Center, 55 Fruit Street, Boston, MA 02114, United States
| | - Mizuki Nishino
- Department of Radiology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA 02215, United States
| | - Aileen B Chen
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA 02215, United States
| | - Lynette M Sholl
- Department of Pathology, Brigham and Women's Hospital, Boston, MA 02215, United States
| | - Matthew H Kulke
- Center for Gastrointestinal Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, United States
| | - Ciaran J McNamee
- Division of Thoracic Surgery, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02215, United States
| | - Pasi A Jänne
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, United States; Belfer Institute for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, MA 02215, United States
| | - Bruce E Johnson
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02215, United States.
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Yazıcıoğlu A, Yekeler E, Bıcakcıoğlu P, Ozaydın E, Karaoğlanoğlu N. Synchronous bilateral multiple typical pulmonary carcinoid tumors: a unique case with 10 typical carcinoids. Balkan Med J 2012; 29:450-2. [PMID: 25207053 DOI: 10.5152/balkanmedj.2012.081] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2012] [Accepted: 08/28/2012] [Indexed: 11/22/2022] Open
Abstract
Bilateral multiple typical carcinoid tumors of the lung are uncommon malignancies. We discuss the case of a 64 year-old female with a nonproductive cough as the initial symptom. Thoracic computed tomography revealed multiple nodular lesions on both sides, which were initially misdiagnosed as multiple metastases of the lung with an unknown primary. After resection of nodules in the right hemithorax, pathologic examination revealed a typical carcinoid tumor. Bilateral sequential thoracotomy was performed and all ten nodules, (six on the right side and four on the left side), were treated by sublobar resection due to poor respiratory function. Pathological examination revealed all nodules to be typical carcinoid tumors. Following the resections, the patient has remained disease-free for ten months.
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Affiliation(s)
- Alkın Yazıcıoğlu
- Department of Thoracic Surgery, Atatürk Chest Disease and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Erdal Yekeler
- Department of Thoracic Surgery, Atatürk Chest Disease and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | - Pınar Bıcakcıoğlu
- Department of Thoracic Surgery, Atatürk Chest Disease and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
| | | | - Nurettin Karaoğlanoğlu
- Department of Thoracic Surgery, Atatürk Chest Disease and Thoracic Surgery Training and Research Hospital, Ankara, Turkey
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Aubry MC, Thomas CF, Jett JR, Swensen SJ, Myers JL. Significance of multiple carcinoid tumors and tumorlets in surgical lung specimens: analysis of 28 patients. Chest 2007; 131:1635-43. [PMID: 17400673 DOI: 10.1378/chest.06-2788] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The clinical significance of multiple carcinoid tumorlets in surgical lung specimens has not been systematically analyzed. We reviewed our experience to determine the range of clinical circumstances associated with this finding. METHODS We reviewed clinical records, available imaging, and pathology materials from patients evaluated at Mayo Clinic Rochester (from 1987 to 2000) with two or more carcinoid tumors or tumorlets in lung specimens. RESULTS Twenty-eight of 294 patients with a diagnosis of carcinoid tumor or tumorlet had two or more lesions. Twenty-six patients (93%) were women; mean age was 65 years. Patients were categorized into three groups: multiple nodules (n = 17), solitary lung nodules on preoperative imaging (n = 7), and airflow limitation (n = 4). Approximately half of patients with multiple nodules had respiratory complaints; two patients had Cushing syndrome. Ten patients (58.8%) were suspected of having pulmonary metastases, including 7 patients with previously diagnosed malignancies. Intrathoracic lymph node metastases were present in three patients, none of whom had recurrent disease. One patient had a carcinoid tumor resected 8 years later. Extrathoracic metastases developed in another patient 3 years after presentation, and the patient was alive with disease 2 years later. Only one patient with airflow limitation had a syndrome resembling diffuse idiopathic pulmonary neuroendocrine cell hyperplasia. CONCLUSIONS Our series represents the largest compilation of multiple carcinoid tumors or tumorlets. Our analysis reveals that multiple carcinoid tumors or tumorlets occur most commonly in patients with multiple nodules resembling metastatic disease. Significant airflow limitation is rare. Long-term survival is excellent, although patients have persistent disease.
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Affiliation(s)
- Marie-Christine Aubry
- Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
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